CLABSI CLABSI Diagnosis Primary Blood Stream Infection in

CLABSI

CLABSI Diagnosis • Primary Blood Stream Infection in patient that has a CVL and either: • 1: Recognized pathogen in one or more blood culture bottle AND organism is not related to infection at another site OR: • 2: Patient has either fever, chills or hypotension AND no other suspected site of infection AND matching positive blood cultures in two or more bottles with common commensal

CLABSI

CLABSI Considerations • Central Line placement: • Use ultrasound to reduce the number of attempts complications • Choose site wisely: • Avoid femoral lines • Subclavian > IJ

Central Line Maintenance • Provider Responsibilities: • • Check the dressings each day with your physical exam Review necessity daily Consider treatments to remove barriers to line removal Place sterile dressing after line and dressing changes are emergencies • Nursing Responsibilities: • • Sterile, transparent, semi permeable dressing Change every 7 days or any time it is soiled Keep area dry Replace ANY dressing that is no C/D/I, ASAP

Central Line Removal • Evaluate the indication for the line each day and remove ASAP • Unsterile Lines (code lines), should be replaced ASAP • Don’t do line exchanges over guide wires (increases risk of infection) • NO CVL, NO CLABSI

Midline Use

Midline Medications

Central Line Insertion Checklist: • • Found in nursing flow documentation Nurses complete in flow sheet Team effort! Lead the way and verify that it’s done

Central Line Insertion Checklist:

Central Line Order Set: • • • Use Central Line Order Set after every line Order CXR Can precheck cathflo Select Line Type Provides Maintenance Orders

• No Central Line = No CLABSI